Perm Medical Journal

The peer-review scientific and practical bimonthly medical journal.

Editor-in-Chief

Olga V. Khlynova, MD, Dr. Sci. (Medicine), Corresponding Member of the Russian Academy of Sciences (Wagner State Medical University). ORCID iD: 0000-0003-4860-0112 

Publisher

Eco-Vector (WEB: www.eco-vector.com)

Founders

About

The journal was founded in 1923 by Medical Society of Perm University (ISSN Key title: Permskiĭ medit︠s︡inskiĭ zhurnal). The journal publish original researches and reviews, case reports and short communications on the following science fields:

  • Obstetrics and Gynecology
  • Oncology, X-ray therapy
  • Surgery
  • Endocrinology
  • Pediatrics
  • Pulmonology
  • Epidemiology
  • Clinical laboratory diagnostic

PubMed News Global

 

Same day discharge versus overnight observation following chronic total occlusion percutaneous coronary intervention: Insights from the PROGRESS-CTO registry

24.03.2023

CONCLUSION: The overall frequency of SDD after CTO PCI was 13% and has been increasing over time. SDD is feasible in select patients following CTO PCI, and radial-only access had the strongest association with SDD.

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Cumulative and undiagnosed SARS-CoV-2 infection among the staff of a medical research centre in Tokyo after the emergence of variants

24.03.2023

To describe the trend of cumulative incidence of coronavirus disease 19 (COVID-19) and undiagnosed cases over the pandemic through the emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants among healthcare workers in Tokyo, we analysed data of repeated serological surveys and in-house COVID-19 registry among the staff of National Center for Global Health and Medicine. Participants were asked to donate venous blood and complete a survey questionnaire about COVID-19...

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Characteristics, treatment and care of pregnant women living with hepatitis B in England: findings from a national audit

24.03.2023

Around 0.4% of pregnant women in England have chronic hepatitis B virus (HBV) infection and need services to prevent vertical transmission. In this national audit, sociodemographic, clinical and laboratory information was requested from all maternity units in England for hepatitis B surface antigen-positive women initiating antenatal care in 2014. We describe these women's characteristics and indicators of access to/uptake of healthcare. Of 2542 pregnancies in 2538 women, median maternal age was...

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GBT021601 improves red blood cell health and the pathophysiology of sickle cell disease in a murine model

24.03.2023

The pathophysiologic mechanism of sickle cell disease (SCD) involves polymerization of deoxygenated haemoglobin S (HbS), leading to red blood cell (RBC) sickling, decreased RBC deformability, microvascular obstruction, haemolysis, anaemia and downstream clinical complications. Pharmacological increase in the concentration of oxygenated HbS in RBCs has been shown to be a novel approach to inhibit HbS polymerization and reduce RBC sickling and haemolysis. We report that GBT021601, a small molecule...

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Current Issue

Vol 40, No 1 (2023)

Cover Page

Full Issue

Original studies

Connection of individual typological features of personality with nature of dreams
Bulatova I.A., Vanyukov V.V., Tyutyunshchikova V.D.
Abstract

Objective. To study the influence of the temperament, anxiety level, intro-extraversion index, the nature of emotions, the level of happiness and the presence of pathologies of sleep physiology in the individual on the frequency of dream production and their figurative content.

Materials and methods. The research involved 100 respondents – students of E.A. Vagner Perm State Medical University, the average age was 22.5 ± 4.5 years. The study was conducted through anonymous questionnaires using the following personality questionnaires and psychological tests: Eysenck Personality Questionnaire, Comprehensive Sociometric Test: Emotions, Oxford Happiness Questionnaire (OHQ), Comprehensive Test for Detection of Sleep Disorders.

Results. It was found that in 37,7 % of cases out of 100,0 %, the imaginative content of dreams and the frequency of their production directly depend on the temperament of the individual, the level of anxiety affects dreams only in 50,0 % of cases out of 100,0 %. The intro-extraversion index has a significant impact on the nature of dreams and manifests its effect in 61,6 % out of 100,0 %. The complete dependence of the imaginative content of dreams on the quality of emotions is observed in 57.0 % of cases; inversely proportional dependence is noted in 43.0 % of cases. It was determined that the level of happiness has a natural effect on dreams in 66.0 % of cases. Sleep disorders can affect both negatively and positively the imaginative content of dreams and their quantitative production. Assessment of the multifactorial influence of the students' psycho-emotional state showed that the most important role in the cumulative effect on sleep and dreams is played by the level of anxiety and temperament.

Conclusions. Changes in the parameters of dreams are a consequence of the multifactorial interaction of individual psycho–emotional characteristics and typological characteristics of the personality. Determination of temperament and registration of the level of anxiety of the individual can contribute to the prediction of the overall picture of dreams for use in psychological and psychiatric practice.

Perm Medical Journal. 2023;40(1):5-15
pages 5-15 views
Features of sleep organization in students of Perm higher educational institutions
Kalashnikova T.P., Polygalova N.L., Yaroshenko A.A., Bakunina E.S., Selezeneva D.R.
Abstract

Objective. To assess the quality of sleep in students of higher educational institutions of Perm taking into account the profile, anxiety level and social employment.

Materials and methods. The study enclosed 300 students of three higher educational institutions of Perm. The features of sleep were analyzed on the basis of questioning followed by statistical treatment of the obtained data.

Results. For all the students, the prevalence of the borderline parameters with subjective assessment of the quality of sleep was a general feature. The students of medical university with a high subjective assessment of the quality of sleep had an excessive daytime sleepiness (50 % of respondents). Medical students were characterized by a night and twenty-four-hour operating schedule and a more expressed situational anxiety. For the students of humanitarian and pedagogical institutions, combination of a high level of personal anxiety with low parameters of the quality of sleep were typical. Sleep was characterized by a long falling asleep with frequent awakening during the night, plenty of dreams often anxious by their content. At the same time, most students preferred work in the daytime. This group of students had a maximum risk for the development of sleep apnea. The students of polytechnic university appeared to be less vulnerable. However, the analyzed subjective characteristics of sleep among most of them demonstrated the borderline disorders, less than 1/3 of them had optimal parameters.

Conclusions. The obtained results put the question of optimizing organization of sleep and wakefulness among students of higher educational institutions, prevention of disorders of circadian rhythms and their consequences, elevation of students’ information awareness on reciprocal influence of sleep and wakefulness. If necessary, there should be a possibility of correction by a somnologist and/or psychotherapist.

Perm Medical Journal. 2023;40(1):16-26
pages 16-26 views
Immunogenetic parameters in children with atopic diseases
Illek Y.Y., Suetina I.G., Khlebnikova N.V., Suslova E.V., Savinova M.V., Dudyreva E.V., Zemtsova E.V.
Abstract

Objective. To determine the features of the distribution of antigens of the major histocompatibility complex in children of preschool and primary school age with atopic diseases.

Materials and methods. Under observation there were children with a moderate course of the diseases such as atopic dermatitis, atopic dermatitis with concomitant persistent allergic rhinitis, independent persistent allergic rhinitis, atopic bronchial asthma. The patients were identified class I and class II antigens of HLA-complex.

Results. The studies have shown that patients with atopic dermatitis had a high incidence of HLA B15, DRB1*13 and DQB1*0602-8: in patients suffering from atopic dermatitis with concomitant persistent allergic rhinitis – HLA B12, B13 and DQB1 * 01; in patients with independent persistent allergic rhinitis – HLA A10 and DQB1 * 201; in patients with atopic bronchial asthma – HLA B18.

Conclusions. Representation of these antigens of the HLA complex in the tissues was associated with an increase in the risk of atopic diseases by 2.3–4.6 times.

Perm Medical Journal. 2023;40(1):27-33
pages 27-33 views
Clinical and laboratory phenotype of postcovid asthenic syndrome in children of primary school age
Vinogradov E.I.
Abstract

Objective. To determine the clinical and laboratory features of the postcovid syndrome in children of primary school age.

Materials and methods. The analysis of complaints and anamnesis, somatic and neurological status in 24 children who had a new coronavirus infection was carried out; the results were also analyzed according to the Subjective Asthenia Scale (version for parents), the Quality of Life Assessment Scale (version for children), the Wayne’s questionnaire and scheme, the functional status scale. The concentration of monocytic chemotactic factor in the saliva was determined using enzyme immunoassay.

Results. Most of the children presented astheno-vegetative complaints, which were confirmed by the MFS scores, and the Wayne's questionnaire and scheme. The concentration of monocytic chemotactic protein in the examined cohort of children was 32.48 ± 23.22 pg/ml, with no significant difference by sex. The level of physical functioning by the quality of life scale was significantly higher in boys (100.00 ± 0.00 points) than in girls (82.03 ± 15.46 points, p = 0.02). A correlation was obtained between the salivary monocyte chemotactic protein content and the scores obtained using the Wayne questionnaire and scheme, as well as the MFS and functional status scales.

Conclusions. Vegetative and asthenic syndromes are closely related to the concentration of salivary monocyte chemotactic factor.

Perm Medical Journal. 2023;40(1):34-40
pages 34-40 views
Complicated clinical variants of mucoperiodontal lesions: desquamative gingivitis
Gileva O.S., Libik T.V.
Abstract

Objective. To study the frequency, clinical and topographic features, risk factors for development, quality of primary diagnosis and treatment of desquamative gingivitis in patients with chronic pathology of the oral mucosa.

Materials and methods. A cohort cross-sectional clinical study with elements of sociological analysis of patients (n = 314; 99 males and 215 females aged 18 to 62 years), who visited the medical advisory center for oral mucosal diseases (OMD) was conducted. According to the results of clinical and laboratory studies, the diagnosis of the main oral mucosal disease was formulated, and patients with desquamative gingivitis were isolated into a separate group. Hygienic (OHI-S) and periodontal (PMA, BoP, PBI, CPITN) indices were evaluated, and impact of oral pathology on the patient’s quality of life using OHIP-49-RU index was assessed for objectification of periodontal status.

Results. High (17.8 %) incidence of desquamative gingivitis was found in patients with chronic oral mucosal diseases of predominantly autoimmune origin (lichen planus, pemphigus vulgaris, erythema multiforme, psoriasis). Desquamative gingivitis develops significantly more often (60.7 %) in women and affects the vestibular surfaces of the anterior-upper dentogingival segment, manifests clinically apparent edema, pain, hemorrhagic and sensory-paresthetic symptoms, which limit the functionality of the patient (chewing, speech, oral hygiene, social communication and professional realization), that significantly reduces the key parameters of patient’s quality of life.

Conclusions. The main reasons for chronization of desquamative gingivitis and low effectiveness of its treatment are the following: low level of polyclinic diagnostics, problems of differential diagnosis, the predominant use of irrational, pathogenetically unjustified means and methods of treatment, as well as the lack of interdisciplinary approaches to the planning of complex therapy.

Perm Medical Journal. 2023;40(1):41-52
pages 41-52 views
Experience of remote monitoring of treatment quality in patients with arterial hypertension during the current pandemic period
Bekhbudova D.A., Akhmedova T.A., Abieva E.M., Israfilbekova F.R., Dadashova G.M.
Abstract

Objective. To conduct a retrospective assessment of the dynamics of blood pressure (BP), the quality of antihypertensive therapy and the frequency of contacts with doctors in conditions of pandemic among patients with hypertension identified during a preventive examination of the population in an organized population of Baku.

Materials and methods. Two groups of patients were studied: group 1 – patients with hypertension who were aware of their disease before the start of the preventive examination; group 2 – patients who were diagnosed hypertension for the first time during the preventive examination. The results of the survey of these patients according to the questionnaire by means of telephone contacts, which includes questions regarding the control of blood pressure (BP), taking antihypertensive drugs, frequency of visiting doctors for 2 years after the initial preventive examination were studied.

Results. The results, obtained in group 1, indicate that taking antihypertensive drugs without periodic medical control over the effectiveness of therapy in most cases does not allow achieving the target values of blood pressure. The results, obtained in group 2, demonstrate poor adherence of patients to medical recommendations and justify the need to create a system of active detection and monitoring of persons with hypertension, who do not know about their disease.

Conclusions. It is necessary to create such a system of remote monitoring of newly identified and registered patients with hypertension, which based on modern technological advances, would allow patients to contact doctors (including remote ones) with a calculated frequency, and thus would ensure regular monitoring of the quality of treatment and adherence to recommendations regarding the treatment and prevention of cardiovascular diseases.

Perm Medical Journal. 2023;40(1):53-60
pages 53-60 views

Review of literature

Morphology and functioning of limbic system: literature review
Torsunova Y.P., Afanasieva N.V.
Abstract

Literature review on the structure and functioning of limbic system is presented in this article. Nowadays, in medical science there is a problem of the lack of systematic data regarding limbic system, because scientists often explore only one aspect of the structure or functioning of the system components. This review is aimed at overcoming this problem. The method of research involves analysis of numerous scientific articles, which are published in Cyberleninka, Nature, Medscape, National Library of Medicine etc. as well as educational literature on fundamental medical disciplines. It was established that there are available different influences of limbic system structures on behavior, cognitive function, motivation and body as a whole. Therefore, to study the limbic system, scientists should use an integrated approach and consider the limbic system specificity from the point of view of anatomy, histology, physiology and biochemistry.

Perm Medical Journal. 2023;40(1):61-77
pages 61-77 views
Plasma dyslipidemia: pathogenesis and diagnostic value. Literature review
Artemenkov A.A.
Abstract

This review discusses the problem of diagnostics of atherosclerosis from the standpoint of the need of developing new approaches and principles for more effective detection of this disease at the early stages of its course in the humans. The insufficiently studied basic stages and mechanisms of lipid metabolism are indicated, which in the future may have diagnostic value. The lipid composition of blood plasma and its fractions, which are associated with a high risk of the occurrence and development of cardiovascular disease (CVD) is assessed. The determining of the role of cholesterol, lipoproteins and apolipoproteins in the pathogenesis of atherosclerosis, a wide variability of the atherogenic lipid profile and its direct relationship with calcium metabolism in atherosclerotic damage of the vascular wall is accentuated. It is shown that the basis of dyslipidemia and civilization diseases (atherosclerosis, obesity, diabetes mellitus) is a disorder of the mechanisms of neurohumoral regulation of lipid metabolism. The immunological mechanisms of the pathogenesis of atherosclerotic process and the marker signs that identify this process are discussed in details. A generalized scheme of peroxidation of blood plasma lipoproteins and the subsequent molecular-cellular stages of the formation of atherosclerotic plaques in the intima of the vascular wall is presented. The current modern methods of diagnosing dyslipidemia are briefly described and the lipid-lowering effects of certain drugs are noted, a forecast is given for the creation of new, more effective statins. In conclusion, the work confirms the importance of studying the qualitative composition of lipids and the expansion of physico-chemical and molecular genetic diagnostic methods for studying metabolism.

Perm Medical Journal. 2023;40(1):78-93
pages 78-93 views
Influence of intestinal microbiota on pathogenesis of cardiovacular diseases
Stepanov M.S., Karpunina N.S., Khlynova O.V., Tuev A.V., Godovalov A.P.
Abstract

The intestinal microbiota is a marker of the organism state, capable of direct and indirect interacting. The main mechanisms underlying interactions are immunoregulation and energy metabolism. Metabolites, formed during the life of microbiota, realize their actions through these engagements. Some metabolites arouse negative effects on endothelial vessels, causing and maintaining a systemic inflammatory response, which stands behind major cardiac risk factors. Metabolites and molecules such as lipopolysaccharide or trimethylamine N-oxide initiate endothelial dysfunction, and thus trigger the processes of atherogenesis, insulin resistance and even increase blood pressure by activating inflammasomes and pro-inflammatory cytokines. Short-chain fatty acids including the main metabolites such as acetate, propionate and butyrate are antagonists of lipopolysaccharide and trimethylamine N-oxide. These substances are a source of energy for intestinal epithelial cells. They maintain homeostasis, stimulate the production of anti-inflammatory components and activating reparative processes. Another important factor influencing levels on blood pressure and systemic inflammation is intestinal barrier dysfunction, which is determined by the regulatory protein zonulin. Besides, there are proved receptor interactions, as well as qualitative and quantitative changes in the composition of the microbiota that can influence blood pressure and atherogenesis. Each cardiovascular disease is characterized by its own microbiological pattern and the predominance of specific metabolites. The article presents a review, summarizing experimental and clinical data on the role of microbiota in the development of atherosclerosis and cardiovascular diseases.

Perm Medical Journal. 2023;40(1):94-107
pages 94-107 views

Methods of diagnosis and technologies

Assessment of orthopedic treatment quality in patients with complete absence of teeth
Bazhin A.A., Kazakov S.V., Ursaky O.N., Starkova A.V., Astashina N.B.
Abstract

Objective. To evaluate the effectiveness of dental orthopedic treatment in patients with complete absence of teeth using removable plate prostheses applying integral qualitative and evaluative indicators. The relevance of the study is dictated by the need to improve the quality of orthopedic treatment in patients with complete absence of teeth, through the introduction of new composite materials, the use of which provides high strength of prosthetic structures. For an objective assessment of the effectiveness of dental orthopedic treatment of patients using removable plate prostheses, integral approaches based on the calculation of qualitative and evaluative indicators have been modified.

Materials and methods. In order to improve the quality of orthopedic treatment of patients with complete absence of teeth, a design of a complete removable plate prosthesis with a combined basis and a method of its manufacture based on the use of digital technologies was developed. In the course of the work, the evaluation of the effectiveness of treatment in patients with complete absence of teeth in the long-term follow-up using integral qualitative and evaluative indicators was carried out.

Results. Clinical and laboratory stages of manufacturing a new design combining analog and digital metols were developed and tested. As a result of clinical studies, it was found that the type of construction of a complete removable plate prosthesis does not significantly affect the indicator of the integral assessment of the quality of orthopedic treatment, with the exception of the criterion of the prosthesis integrity.

Conclusions. To conclude, it was found that the type of construction of a complete removable plate prosthesis does not significantly affect the integral assessment of the quality of orthopedic treatment, except for the criterion of the integrity of the prosthesis; the introduction of a composite material based on fiberglass into the design of a combined prosthesis allows to improve the strength properties of the prosthesis basis and increase the performance characteristics of the structure. The use of CAD / CAM technologies provides the possibility of using high-strength composite materials, gives sufficient accuracy in the manufacture of the frame of a combined full removable plate prosthesis. Due to satisfactory physical and mechanical properties, the application of the developed design contributes to the predicted increase in the durability of prostheses.

Perm Medical Journal. 2023;40(1):108-116
pages 108-116 views
Psychological support algorithms for underground miners to assess hypertension development risk
Malyutina N.N., Sedinina N.S., Paramonova S.V.
Abstract

Objective. To study the psychovegetative status of underground miners and form psychological support algorithms to identify the risk for developing hypertension. Hypertension occupies a leading place in the structure of cardiovascular diseases, and determining the risk of its development is of great preventive importance for professional longevity. The study of the psychovegetative status to identify the risk of this pathology corresponds to modern diagnostic approaches within the framework of industrial corporate programs.

Materials and methods. There were examined 109 male underground miners of the enterprise for the extraction of chromium ore. The patients were divided into two groups: the main group – 60 men working in underground conditions, whose work is classified as "harmful" (class 3.3–3.4); the comparison group – 49 men engaged in ground works, the conditions of which are classified as class 3.2. The main group was divided into two subgroups: I – workers under 45 years old (n = 20, age 38.45 ± 2.95 years), II – over 45 years old (n = 40, age 50.90 ± 1.46 years.); the comparison group was divided accordingly (23 employees, aged 38.0 ± 2.8 years, experience – 9.3 ± 1.5 years; comparison group <45 years and 26 employees, aged 49.2 ± 2.1 years, experience – 24.0 ± 1.8 years; comparison group >45 years). A complex of research methods was used: analytical (analysis of special assessment cards of working conditions, sociodemographic questionnaires), psychophysiological, functional and clinical and laboratory diagnostics, mathematical statistics (ROC analysis, multivariate logistic regression).

Results. In two subgroups, two phenotypes were identified; in group I, there was a correlation of psychovegetative indicators with age and experience, and in group II – a negative correlation. It has been proved that, depending on age, the psychologically realized adaptive phenotype is transformed into a psychosomatic one.

Conclusions. Diagnostics of phenotype transformation formed the basis of the developed algorithms for psychological support, which makes it possible to assess the risk for developing arterial hypertension.

Perm Medical Journal. 2023;40(1):117-128
pages 117-128 views

Preventive and social medicine

Clinical and epidemiological aspects of enterobiosis in children
Arakelyan R.S., Larina N.S., Kurbangalieva A.R., Sivtsova L.A.
Abstract

Objective. To study and analyze the clinical and epidemiological picture of the incidence of enterobiosis in children living in the Astrakhan Region for 2017–2021.

Materials and methods. During the work, epidemiological maps of persons with a confirmed diagnosis of Enterobiosis were analyzed, which was identified on the basis of laboratory data (detection of pinworm eggs in perianal folds and feces).

Results. From 2017 to 2021, in the Astrakhan Region, 12 627 cases of human infection with helminth-protozoal infestations were registered, of which 94.9 % (11 982 cases) were children under the age of 17. The share of cases of enterobiosis in children in the structure of the total childhood parasitic morbidity for the analyzed period was 84.1 % (10 071 cases). Thus, enterobiosis was registered in all age groups, most often occurring in children aged 7 to 17 years – 59.1 % (5950 cases). A slightly smaller number of cases of enterobiosis was registered in children aged from 1 to 7 years – 40.0 % (4026 cases); a minimum of enterobiosis cases was registered in children aged 5 to 12 months – 0.9 % (95 cases). Enterobiosis was identified both in urban and rural areas, most often detected in children living in the rural areas of the Astrakhan region – 53.5 % (5,393 cases).

Enterobiosis was diagnosed during preventive examinations before going to school or kindergarten – 72.7 % (7325 cases). Another part of the children – 20.4 % (2053 cases) sought medical help at medical institutions due to the presence of clinical symptoms of the disease. In rare cases – 6.9 % (693 cases) children were examined as contact ones by one of the family members. As a rule, the clinical picture was noted only in children who addressed for medical help in connection with complaints and symptoms of the disease – 20.4 % (2053 children). In all the cases described by us, children had a mild form of enterobiosis manifested by itching in the perianal region, which occurred in the evening and/or at night – 96.8 % (1987 children), poor sleep – 47.7 % (979 children), nausea – 8.5 % (174 children).

Conclusions. Enterobiosis is most often registered in childhood than in adulthood. Most often enterobiosis infection with pinworms affects children aged 7–17 years. The main reason for infecting children is the presence of onychophagy, geophagy and contact with pets, on the wool of which pinworm eggs can persist for a long time.

Perm Medical Journal. 2023;40(1):129-135
pages 129-135 views

Clinical case

Clinical case of development of thromboembolism after thyroidectomy with concomitant diseases
Styazhkina S.N., Kiryanov N.A., Zaitsev D.V., Tikhomirova G.I., Fedulova T.V., Filonenko M.V., Shamilova Y.F., Rybakov I.V.
Abstract

Objective. To study a clinical case after a planned thyroidectomy. Venous thromboembolism in the form of deep vein thrombosis or LE is the third most common in the world, being the second only to myocardial infarction and stroke. In epidemiological studies, the annual incidence of pulmonary embolism ranges from 39 to 115 persons per 100 000 of the population; for deep vein thrombosis, the incidence rates range from 53 to 162 per 100 000 of the population. The cross-sectional analysis data show that the frequency of venous thromboembolism is almost 8 times higher in persons over 80 years of age than in the fifth decade of life. Pulmonary embolism is a stop of blood flow in the branch of the pulmonary artery due to obstruction by a clot. The most frequent places of blood clots are the deep veins of the lower extremities. Risk factors for thromboembolism may be surgical operations, varicose veins, age, overweight. This is one of the most common and severe complications of the postoperative period. Our article considers a clinical example of the development of thromboembolism after thyroidectomy, presents the results of pathomorphological studies, autopsy, histological studies.

Materials and methods. The work consisted in the study of a clinical case of pulmonary embolism after a planned surgical intervention for nodular goiter. Histological sections of organs such as the heart, kidneys, gallbladder, thyroid gland, liver were studied.

Results. The results of our study showed that thyroidectomy refers to operations of a high complexity and high risk of multiple complications as well as the occurrence of a fatal outcome. Therefore, a thorough examination of all organs and systems in patients is necessary, especially those who belong to the elderly and severe comorbid pathology groups. This is due to the fact that the risk of death without a proper preparation for surgery with available concomitant diseases (nodular colloidal goiter, empyema of the gallbladder, Gilbert's disease, persistent hepatitis, type 2 diabetes mellitus, hypertension, chronic coronary heart disease) was very high for this patient.

Conclusions. Diffuse nodular toxic goiter is a complex surgical pathology involving many organs and systems. Patients with such a diagnosis require a thorough history collection, carrying out clinical, instrumental and laboratory research methods, including successful surgical intervention.

Perm Medical Journal. 2023;40(1):136-141
pages 136-141 views
Phosphate diabetes: a clinical case of family hypophosphatemic rickets
Miftakhova A.M.
Abstract

Objective. To describe the clinical picture of the course of hypophosphatemic rickets in two members of the same family. Phosphate diabetes is a rare hereditary pathology of mineral and bone metabolism.

Materials and methods. There is presented a clinical picture of the course of hypophosphatemic rickets in two members of the same family.

Results. According to the results obtained, there is a clear difference in the severity of the disease course depending on the sex. The child's mother had a course of the disease with a late onset and complications from the lower extremities, but the patient was able to bear and give birth to a child on her own. The boy had an early detection, early progression of complications of the skeletal system with visual impairment and neurological symptoms (headaches, intracranial hypertension).

Conclusions. The clinical example is relevant for practitioners. It is necessary to develop algorithms for monitoring the complications of phosphate diabetes and searching for pathogenetic therapy.

Perm Medical Journal. 2023;40(1):142-150
pages 142-150 views

Biology and experimental medicine

Morphological assessment of changes in internal organs of rats with introduction of targeted drug “Sutent” in experiment
Gulyaeva N.I., Vdovina G.P., Freind G.G., Burlutskaya A.A., Chugunova M.P., Karipova M.O.
Abstract

Objective. To establish in the experiment the changes in histological structure of the internal organs and blood indices in laboratory rats with intragastric introduction of the drug Sutent® in the doses of 7 mg/kg and 35 mg/kg of the weight.

Materials and methods. The study was conducted on 48 breedless white rats divided into the following groups: groups 1 and 4 – received cytotoxic drug Sutent® in the dose of 7 mg/kg (therapeutic dose), groups 2 and 5 – Sutent® in the dose of 35 mg/kg (fivefold exceeding the therapeutic dose), groups 3 and 6 – the control groups. In groups 1, 2, 3 animal were killed 30 days after the onset of the experiment, in groups 4, 5, 6 – two weeks after the drug withdrawal. Every day during 30 days, the experimental groups were introduced the intragastric drug Sutent® in the form of aqueous suspension in the purified water; in the control group the rats received the purified water in the equivalent volume. The histological preparations of organs stained with hematoxylin and eosin as well as the hematological indices of blood were investigated.

Results. The development of hypochromic anemia, thrombocytopenia and granulocytopenia in the was identified. While studying the histological structure of organs, in all experimental groups there was detected a disturbed circulation in the form of venous hyperemia and blood stasis in the capillaries, the development hemorrhages in the lung, liver, kidneys, adrenal glands, pancreas, gastric and esophageal mucosa. In the liver, pancreas and adrenal glands, dystrophic changes in the cells and necrosis foci were observed. In group 2, affection of the cerebral cortex nerve cells, heart cardiomyocytes, thyroid cells, acute duodenitis with formation of microabscesses was established.

Conclusions. Introduction of Sutent® in the dose of 35 mg/kg, compared with the dose of 7 mg/kg, caused a more expressed hematological, hepatological, cardiological and neurological toxicity, more obvious lesion of endocrine organs; it also contributed to the development of associated secondary infection and acute duodenitis.

Perm Medical Journal. 2023;40(1):151-163
pages 151-163 views

Memorial date

Dedicated to Veniamin Arsenievich Sitnikov (1936–2022), honoured doctor of the Russian Federation
Styazhkina S.N., Voinova A.A., Tursukova P.A.
Abstract

The article is dedicated to the memory of the Honoured Doctor of the Russian Federation, Doctor of Medical Sciences, member of the European Association of Intensive Care, Academician of the Russian Academy of Laser Sciences, outstanding professor, member of the International Association of Hepatologists, Veniamin Arsenyevich Sitnikov.

Perm Medical Journal. 2023;40(1):164-167
pages 164-167 views


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